Diabetes complications

Algorithm for emergency care in diabetic coma, episodes of hyperglycemia and hypoglycemia

Diabetes mellitus of any type requires constant monitoring of blood glucose levels at home.

When this indicator exceeds all permissible norms, urgent action is required to take appropriate measures aimed at reducing the dangerous threshold.

If you do not treat the disease and do not try to reduce the concentration of glucose, hyperglycemia occurs, which the body cannot cope with without help from outside. The absence of further actions aimed at the normalization of indicators may lead to the onset of coma and death.

To avoid this, it is necessary to know the first symptoms of a dangerous condition, as well as be able to provide first aid to a diabetic.

Coma and ketoacidosis: inpatient diagnosis

Hyperglycemic coma in most cases is accompanied by ketoacidosis. Usually, this condition occurs in elderly patients who do not control the level of sugar in the blood.

But young diabetics may suffer from this manifestation. If there is an acute shortage of insulin in the patient's body, the cells lose the ability to break down carbohydrates, as a result of which they cannot receive the energy necessary for life.

The result is a switch to eating fats. After the breakdown of fatty compounds, the production of ketone bodies and acetone occurs, the acidity of the blood is disturbed, and a dangerous process begins - ketoacidosis.

But this is not always the case. In cases where the patient's body does not go on nutrition fats, hypersolar syndrome occurs, as a result of which the blood becomes too thick.

When the patient enters the hospital, the doctors first find out whether the patient has ketoacidosis.

To this end, pass a rapid analysis of urine for ketone bodies. The patient also undergoes a blood test for APTT, since the coagulability of blood is disturbed during hyperosmolar syndrome.

However, no less important is the ability to self-diagnose a dangerous condition at home. Therefore, the patient and his associates should be familiar with the types of coma, as well as the causes, symptoms and rules of first aid.

Types of diabetic coma, symptoms and first aid

It is believed that the cause of coma is only an excessive increase in blood sugar levels. In fact, such a judgment is a fallacy.

Diabetic coma can be of the following types:

  • hypoglycemic;
  • hyperosmolar (hyperglycemic);
  • ketoacidotic.

The rules for first aid will also vary.


This condition occurs predominantly in patients suffering from type 1 diabetes and taking insulin injections. However, in some cases, hypoglycemic coma can also develop in non-insulin dependent diabetics who take sugar reducing agents in pills.

As a result, a large amount of insulin accumulates in the blood. This condition is dangerous for brain tissue and NS.

Among the factors contributing to the development of hypoglycemic coma are:

  • physical injury;
  • insufficient intake of foods containing carbohydrates;
  • moral and stressful situations;
  • excessive use of insulin.

When it occurs, the patient feels weak, sweating, tremors in the limbs, gradually turning into convulsions, as well as increased fatigue and irritability.

The behavior of a diabetic in such a situation may become unmanageable. He loses the ability to navigate in space and subsequently loses consciousness.

Therefore, it is necessary to immediately stop the developing attack. To do this, give the patient a few pieces of sugar, 2-3 tablespoons of honey or 100 g of sweet cookies.

If a diabetic has a severe coma, it is necessary:

  • insert a retainer between the jaws (you can use any household object of an oblong shape: for example, the handle of a massage brush) and pour warm tea in the patient's mouth, prepared at the rate of 3-4 spoons of sugar per 1 cup (if the diabetic has not lost his swallowing abilities);
  • feed diabetic carbohydrate foods (cereals, fruits, flour products);
  • the next morning, reduce the dosage of insulin by 4-8 units.
If the onset of coma is accompanied by a sudden loss of consciousness, the patient is administered intravenous glucose (40-80 ml) and call an ambulance.

Hyper-molar / hyperglycemic

This condition occurs mainly in patients older than 50 years.

Usually the cause of the development of hypersolar coma is:

  • gastrointestinal tract disease;
  • injuries and surgeries;
  • use of diuretics and immunosuppressants;
  • carbohydrate abuse.

Upon the onset of hyperosmolar coma, the patient feels cramps, intense thirst and frequent toilet tending, drowsiness, speech and main reflexes.

If a diabetic symptoms of coma were found, the following measures should be taken:

  • put the patient down;
  • enter the air duct to prevent the language from falling down;
  • normalize blood pressure;
  • inject 10-20 ml of 40% glucose solution intravenously;
  • call an ambulance.
First aid should be given immediately after the initial manifestations of hyperglycemic coma.


The circumstances contributing to the development of ketoacid coma are the following points:

  • improper treatment or late diagnosis of diabetes;
  • surgery and injuries;
  • generic activity;
  • stressful situations;
  • violation of the diet;
  • purulent infections;
  • some other circumstances.

In this situation, the patient feels thirst, nausea, general weakness, and the need for frequent visits to the toilet. In case of aggravation of the condition, acute pain in the lower abdomen, vomiting, noisy breathing, the smell of acetone appears, after which the patient loses consciousness and falls into a coma.

In the event of a ketoacid coma, it is necessary to urgently call an ambulance, and before the arrival of specialists to maintain the heartbeat and breathing of the patient.

Ketoacidosis usually develops within a few days, so it can be easily avoided by taking appropriate measures after identifying its primary manifestations.

What to do if the type of coma is not defined?

In some situations, diabetic relatives panic and cannot determine for sure what kind of coma came from a loved one.

Also, the situation may be complicated by mixed symptoms, which makes diagnosis at home is almost impossible. In such situations, do not waste time on assumptions. Immediately call an ambulance.

Before the arrival of the ambulance, you can carry out the following manipulations:

  • intramuscularly inject 6-12 units of insulin;
  • under conditions of tangled consciousness, make an enema with soda solution;
  • Allow the patient to drink alkaline mineral water.

But still the most effective way to fight will be an early call for ambulance and professional actions of doctors.

In the case of deterioration of the condition, urgent hospitalization and subsequent treatment of the patient in inpatient conditions may be required.

In order to avoid aggravation of the condition and the onset of coma, it is necessary to constantly monitor the level of sugar in the blood with a home glucometer, and in the event of an increase or a sharp drop, take appropriate measures aimed at normalizing this indicator.

Maintaining a normal state of health will help adherence to the diet, prescribed by the doctor dosages and intensity of medication.

Related videos

About symptoms and first aid for diabetic coma in the video:

In order to be able to correctly provide first aid for the onset of coma of any type, the relatives of the patient should carefully study the symptoms of the dangerous state at different stages, as well as familiarize themselves with the actions necessary to eliminate it.

It is not excluded that such knowledge can not only quickly alleviate the health of the diabetic, but also save his life.

Watch the video: Diabetes mellitus type 1 (April 2020).